Re: Coding issue for cytology-does anyone believe this?

From:

Jennifer MacDonald

We routinely billed for special stains (88312, 88313) on our cytology
cases, particularly on the bronchial washings that we did GMS, AFB and GRAM
stains. They were not "kicked back" by the billing department or the
insurance companies. You may have to sit with your billing department to have
those CPT codes associated with the cytology cases as well. There were
times that we had to educate the billing department on the histology/cytology
billing.

I'd be grateful to hear from anyone who considers themselves
knowledgeable about CPT coding in regards to the following:

Our billing dept is kicking back bills on cytology samples that have had
special stains performed BECAUSE the CPT code book description for special
stains (88312 and 88313) reads as follows:

"special stains (list separately in addition to code for surgical
pathology examination), Group I (or II)"

there is no mention of cytology samples in the descriptive for special
stains, only surgical pathology, which implies that stains cannot be billed on
cytology samples. There are no separate codes for special stains performed on
cytology samples.

We had a bronchoscopy specimen on an immunosuppressed patient stained for
AFB and Fungus kicked back. By the way, it was not kicked back by the
insurance co. our billing department has it's own software to clean up bills
to reduce the number of rejected claims.

Is the use of stains on cytology samples not the standard of care and do
you know if you are getting paid for doing them?